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Individual
STACY L MCFANN
Active
Individual
STACY L MCFANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C1000490
OH
101YP2500X
Professional Counselor
Primary
E.1000490-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0176548
—
OH
Enumeration date
10/26/2012
Last updated
03/20/2018
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